| NPI | 1649585795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S015592) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441048) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2016-06-14 |